NPI | 1821231754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD435369) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N2431) |
Enumeration Date | 2009-04-07 |
Last Update Date | 2025-02-12 |